The biographical information form must be completed by a person who is one of the following for the franchisor company: director, principal officer, other executives who will manage the franchisees, and franchise brokers.
Kansas Controlling Persons Questionnaire
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Multi-State
Control #:
US-1-02-STP
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FAQ
Disclosure of Ownership and Control Interest Statement The information required includes, but it is not limited to, name, address, date of birth, social security number (SSN) and tax identification (TIN) as described in 42 CFR § 455.106.
The protected income limit for the elderly and people with disabilities is $475.00 for one or two people and $480 for three people. For adults, only the income of the person needing coverage and their spouse is used. For children, the protected income limit is $475.00 for one or two people and $480.00 for three people.
Who is eligible for Kancare (SCHIP)? Household Size*Maximum Income Level (Per Year)1$35,1382$47,5263$59,9134$72,3004 more rows
If in doubt, contact KMAP Customer Service at 1-800-766-9012 (members) or 1-800-933-6593 (providers). KanCare Health Plans. General KMAP program information can be accessed from the menu links above. Users with secure access can log in using the login button.
